Health Insurance Legislation Amendment (Rural Bulk‑billing Incentive) Regulations 2021
I, General the Honourable David Hurley AC DSC (Retd), Governor‑General of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following regulations.
Dated 09 December 2021
David Hurley
Governor‑General
By His Excellency’s Command
Greg Hunt
Minister for Health and Aged Care
Contents
1 Name
2 Commencement
3 Authority
4 Schedules
Schedule 1—Rural bulk‑billing incentive
Health Insurance (Diagnostic Imaging Services Table) Regulations (No. 2) 2020
Health Insurance (General Medical Services Table) Regulations 2021
Health Insurance (Pathology Services Table) Regulations 2020
This instrument is the Health Insurance Legislation Amendment (Rural Bulk‑billing Incentive) Regulations 2021.
(1) Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.
Commencement information | ||
Column 1 | Column 2 | Column 3 |
Provisions | Commencement | Date/Details |
1. The whole of this instrument | 1 January 2022. | 1 January 2022 |
Note: This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.
(2) Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.
This instrument is made under the Health Insurance Act 1973.
Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.
Schedule 1—Rural bulk‑billing incentive
Health Insurance (Diagnostic Imaging Services Table) Regulations (No. 2) 2020
1 Subclauses 1.2.20(3) and 1.2 21(10) of Schedule 1
Omit “or 64991”, substitute “, 64991, 64992, 64993, 64994 or 64995”.
2 Clause 2.6.1 of Schedule 1 (heading)
Repeal the heading, substitute:
2.6.1 Application of items 64990, 64991, 64992, 64993, 64994 and 64995
3 Subclause 2.6.1(1) of Schedule 1
Repeal the subclause.
4 Subclause 2.6.1(2) of Schedule 1
Omit “64990 or 64991”, substitute “64990, 64991, 64992, 64993, 64994 or 64995”.
5 Schedule 1 (item 64990, column 2)
Omit “64991”, substitute “64991, 64992, 64993, 64994 or 64995”.
6 Schedule 1 (item 64991, column 2)
Omit “64990”, substitute “64990, 64992, 64993, 64994 or 64995”.
7 Schedule 1 (item 64991, column 2, paragraph (e))
Repeal the paragraph, substitute:
(e) the service is provided at, or from, a practice location in a Modified Monash 2 area
8 Clause 2.6.2 of Schedule 1 (at the end of the table)
Add:
64992 | A diagnostic imaging service to which an item in this Schedule (other than this item or item 64990, 64991, 64993, 64994 or 64995) applies if: (a) the service is an unreferred service; and (b) the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder; and (c) the person is not an admitted patient of a hospital; and (d) the service is bulk‑billed in relation to the fees for: (i) this item; and (ii) the other item in this Schedule applying to the service; and (e) the service is provided at, or from, a practice location in: (i) a Modified Monash 3 area; or (ii) a Modified Monash 4 area | 11.55 |
64993 | A diagnostic imaging service to which an item in this Schedule (other than this item or item 64990, 64991, 64992, 64994 or 64995) applies if: (a) the service is an unreferred service; and (b) the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder; and (c) the person is not an admitted patient of a hospital; and (d) the service is bulk‑billed in relation to the fees for: (i) this item; and (ii) the other item in this Schedule applying to the service; and (e) the service is provided at, or from, a practice location in a Modified Monash 5 area | 12.25 |
64994 | A diagnostic imaging service to which an item in this Schedule (other than this item or item 64990, 64991, 64992, 64993 or 64995) applies if: (a) the service is an unreferred service; and (b) the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder; and (c) the person is not an admitted patient of a hospital; and (d) the service is bulk‑billed in relation to the fees for: (i) this item; and (ii) the other item in this Schedule applying to the service; and (e) the service is provided at, or from, a practice location in a Modified Monash 6 area | 13.00 |
64995 | A diagnostic imaging service to which an item in this Schedule (other than this item or item 64990, 64991, 64992, 64993 or 64994) applies if: (a) the service is an unreferred service; and (b) the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder; and (c) the person is not an admitted patient of a hospital; and (d) the service is bulk‑billed in relation to the fees for: (i) this item; and (ii) the other item in this Schedule applying to the service; and (e) the service is provided at, or from, a practice location in a Modified Monash 7 area | 14.25 |
Health Insurance (General Medical Services Table) Regulations 2021
9 Clause 3.2.1 of Schedule 1
Repeal the following definitions:
(a) definition of ASGC;
(b) definition of designated area;
(c) definition of SLA;
(d) definition of SSD.
10 Clause 3.2.2 of Schedule 1
Repeal the clause, substitute:
3.2.2 Application of items 10990, 10991, 10992, 75855, 75856, 75857 and 75858
If item 10990, 10991, 10992, 75855, 75856, 75857 or 75858 applies to a medical service, the fee mentioned in that item applies in addition to the fee mentioned in another item in this Schedule that applies to the service.
11 Schedule 1 (item 10990, column 2)
Omit “10991 or 10992”, substitute “10991, 10992, 75855, 75856, 75857 or 75858”.
12 Schedule 1 (item 10990, column 2, paragraph (b))
Omit “patient”, substitute “person”.
13 Schedule 1 (item 10990, column 2, paragraph (c))
Omit “the patient”, substitute “the person”.
14 Schedule 1 (item 10991, column 2)
Omit “10990 or 10992”, substitute “10990, 10992, 75855, 75856, 75857 or 75858”.
15 Schedule 1 (item 10991, column 2, paragraph (b))
Omit “patient”, substitute “person”.
16 Schedule 1 (item 10991, column 2, paragraph (c))
Omit “the patient”, substitute “the person”.
17 Schedule 1 (item 10991, column 2, paragraph (e))
Repeal the paragraph, substitute:
(e) the service is provided at, or from, a practice location in a Modified Monash 2 area
18 Schedule 1 (item 10992, column 2, paragraph (d))
Omit “patient”, substitute “person”.
19 Schedule 1 (item 10992, column 2, paragraph (e))
Omit “the patient”, substitute “the person”.
20 Schedule 1 (item 10992, column 2, paragraphs (g), (h) and (i))
Repeal the paragraphs, substitute:
(g) the service is provided in any of the following areas:
(i) a Modified Monash 2 area;
(ii) a Modified Monash 3 area;
(iii) a Modified Monash 4 area;
(iv) a Modified Monash 5 area;
(v) a Modified Monash 6 area;
(vi) a Modified Monash 7 area; and
(h) the service is provided by, or on behalf of, a medical practitioner whose practice location is not in an area mentioned in paragraph (g); and
(i) the service is bulk‑billed in relation to the fees for:
(i) this item; and
(ii) the other item mentioned in paragraph (a) or (b) applying to the service
21 Clause 3.2.3 of Schedule 1 (at the end of the table)
Add:
75855 | A medical service to which an item in this Schedule (other than this item or item 10990, 10991, 10992, 75856, 75857 or 75858) applies if: (a) the service is an unreferred service; and (b) the service is provided to a person who is under the age of 16 or is a concessional beneficiary; and (c) the person is not an admitted patient of a hospital; and (d) the service is bulk‑billed in relation to the fees for: (i) this item; and (ii) the other item in this Schedule applying to the service; and (e) the service is provided at, or from, a practice location in: (i) a Modified Monash 3 area; or (ii) a Modified Monash 4 area | 12.30 |
75856 | A medical service to which an item in this Schedule (other than this item or item 10990, 10991, 10992, 75855, 75857 or 75858) applies if: (a) the service is an unreferred service; and (b) the service is provided to a person who is under the age of 16 or is a concessional beneficiary; and (c) the person is not an admitted patient of a hospital; and (d) the service is bulk‑billed in relation to the fees for: (i) this item; and (ii) the other item in this Schedule applying to the service; and (e) the service is provided at, or from, a practice location in a Modified Monash 5 area | 13.10 |
75857 | A medical service to which an item in this Schedule (other than this item or item 10990, 10991, 10992, 75855, 75856 or 75858) applies if: (a) the service is an unreferred service; and (b) the service is provided to a person who is under the age of 16 or is a concessional beneficiary; and (c) the persons not an admitted patient of a hospital; and (d) the service is bulk‑billed in relation to the fees for: (i) this item; and (ii) the other item in this Schedule applying to the service; and (e) the service is provided at, or from, a practice location in a Modified Monash 6 area | 13.85 |
75858 | A medical service to which an item in this Schedule (other than this item or item 10990, 10991, 10992, 75855, 75856 or 75857) applies if: (a) the service is an unreferred service; and (b) the service is provided to a person who is under the age of 16 or is a concessional beneficiary; and (c) the person is not an admitted patient of a hospital; and (d) the service is bulk‑billed in relation to the fees for: (i) this item; and (ii) the other item in this Schedule applying to the service; and (e) the service is provided at, or from, a practice location in a Modified Monash 7 area | 14.65 |
22 Subclause 5.5.3(3) of Schedule 1
Omit “items 10990, 10991 or 10992”, substitute “item 10990, 10991, 10992, 75855, 75856, 75857 or 75858”.
23 Clause 7.1.1 of Schedule 1
Repeal the following definitions:
(a) definition of ASGC;
(b) definition of designated area;
(c) definition of SLA;
(d) definition of SSD.
Health Insurance (Pathology Services Table) Regulations 2020
24 Paragraph 1.2.2(b) of Schedule 1
Omit “or 74991”, substitute “, 74991, 75861, 75862, 75863 or 75864”.
25 Clause 2.12.1 of Schedule 1
Repeal the clause, substitute:
2.12.1 Application of items 74990, 74991, 75861, 75862, 75863 and 75864
Despite clause 1.2.1, if item 74990, 74991, 75861, 75862, 75863 or 75864 applies to a pathology service, the fee specified in that item applies in addition to the fee specified in any other item in this Schedule that applies to the service.
26 Schedule 1 (item 74990, column 2)
Omit “74991”, substitute “74991, 75861, 75862, 75863 or 75864”.
27 Schedule 1 (item 74991, column 2)
Omit “74990”, substitute “74990, 75861, 75862, 75863 or 75864”.
28 Schedule 1 (item 74991, column 2, paragraph (e))
Repeal the paragraph, substitute:
(e) the service is provided at, or from, a practice location in a Modified Monash 2 area
29 Clause 2.12.2 of Schedule 1 (at the end of the table)
Add:
75861 | A pathology service to which an item in this Schedule (other than this item or item 74990, 74991, 75862, 75863 or 75864) applies if: (a) the service is an unreferred service; and (b) the service is rendered to a person who is under the age of 16 or is a concessional beneficiary; and (c) the person is not an admitted patient of a hospital; and (d) the service is bulk‑billed in relation to the fees for: (i) this item; and (ii) the other item in this Schedule applying to the service; and (e) the service is rendered at, or from, a practice location in: (i) a Modified Monash 3 area; or (ii) a Modified Monash 4 area | 11.55 |
75862 | A pathology service to which an item in this Schedule (other than this item or item 74990, 74991, 75861, 75863 or 75864) applies if: (a) the service is an unreferred service; and (b) the service is rendered to a person who is under the age of 16 or is a Commonwealth concession card holder; and (c) the person is not an admitted patient of a hospital; and (d) the service is bulk‑billed in relation to the fees for: (i) this item; and (ii) the other item in this Schedule applying to the service; and (e) the service is rendered at, or from, a practice location in a Modified Monash 5 area | 12.25 |
75863 | A pathology service to which an item in this Schedule (other than this item or item 74990, 74991, 75861, 75862, or 75864) applies if: (a) the service is an unreferred service; and (b) the service is rendered to a person who is under the age of 16 or is a Commonwealth concession card holder; and (c) the person is not an admitted patient of a hospital; and (d) the service is bulk‑billed in relation to the fees for: (i) this item; and (ii) the other item in this Schedule applying to the service; and (e) the service is rendered at, or from, a practice location in a Modified Monash 6 area | 13.00 |
75864 | A pathology service to which an item in this Schedule (other than this item or item 74990, 74991, 75861, 75862 or 75863) applies if: (a) the service is an unreferred service; and (b) the service is rendered to a person who is under the age of 16 or is a Commonwealth concession card holder; and (c) the person is not an admitted patient of a hospital; and (d) the service is bulk‑billed in relation to the fees for: (i) this item; and (ii) the other item in this Schedule applying to the service; and (e) the service is rendered at, or from, a practice location in a Modified Monash 7 area | 14.25 |